129 million people in China suffer from diabetes and how to stay away from the "sweet burden".
2021-11-16
In 1985, at the age of 9, he was diagnosed with type 1 diabetes. In the 80s of last century, the public knew little about diabetes, and the whole family learned about diabetes by buying books and learning by themselves. Recalling his childhood experience of sugar control, Yang Kun said: "urine sugar should be tested before three meals and before going to bed, 18 drops of Ban's solution plus two drops of urine, and then burned with an alcohol lamp. After burning, the blood sugar level should be judged according to the color." up to now, he still remembers that when he was a child, he had to use a blue core needle for insulin, so he often bought needles, and these medical devices should be steamed and sterilized every week. Now, it is very easy for Yang Kun to inject insulin. Under the guidance of the doctor, his blood glucose was basically controlled smoothly without complications. In addition, he has obtained diplomas from two universities, and has also been engaged in the public welfare undertakings of diabetes. He founded a sugar Mutual Aid Association and founded a medical device company to provide employment opportunities for patients with type I diabetes. Recently, Yang Kun, who was guided by the secretarial propaganda group of the China Health Promotion Action Committee, and China's family newspaper sponsored "everyone enjoys diabetes health management", 2021, "E of healthy China", the theme of the United Nations Diabetes Day theme live broadcast, and he shared his story. China is one of the fastest growing countries in the world with diabetes prevalence. As one of the four major chronic diseases that China has focused on prevention and control of healthy China (2019~2030), diabetes has become an important chronic disease threatening human health. Mao Qunan, deputy director of the office of the China Health Promotion Action Committee, and director of the planning, development and information technology division of the national health and Health Committee, stressed that diabetes health management needs to be sustained at the level of health education, so that where to focus on the audience and where to focus on the publicity and education work. We need to constantly strengthen the construction of medical and health service system, and comprehensively promote the Internet plus medical health service to the grass-roots level, fundamentally prevent the occurrence of various kinds of diabetic complications, and effectively improve the quality of life of patients. Diabetes is related to obesity and overweight. Guo Lixin, chief physician of Department of Endocrinology, Beijing Hospital, said that diabetes is a disorder of glucose metabolism caused by genetic and environmental factors. People often have misconceptions about the cognition of diabetes. For example, people often say, "don't eat too much sugar and get diabetes." in fact, there is no scientific basis for this statement. There is no necessary link between sugar and diabetes, but if you eat sweet food or sugar drinks for a long time, it will lead to overweight and obesity and increase the risk of metabolic diseases. Diabetes has a certain correlation with obesity and overweight. The probability of having diabetes is significantly higher than that of healthy eating group. Therefore, it is necessary to eat sugar. Another mistake is that under the same conditions, people with family history are more likely to have diabetes than those without family history, but that does not mean they will suffer from diabetes. In addition to genetic factors, about 5%-10% of pre diabetes patients will progress to diabetes every year in China. If they can have healthy diet and exercise during the potential risk period, correct and scientific intervention through healthy lifestyle will probably delay or even avoid the occurrence of diabetes. Guo Lixin said that for patients with diabetes, a reasonable diet, with scientific exercise, according to the doctor's advice to manage blood sugar, while paying attention to blood lipids, blood pressure, control of a variety of metabolic abnormalities, can reduce complications. People with potential diabetes risk should pay attention to: at least 1 fasting blood glucose and glycosylated hemoglobin are detected every year from the age of 40. Try to avoid the bad habits of heavy oil, salt and sugar in diet; Pay attention to exercise and exercise with a certain intensity for at least 150 minutes a week; Weight control with BMI of 24 or less; Avoid excessive mental pressure and keep a happy mood; Avoid staying up late to ensure adequate sleep; Quit smoking and strictly limit alcohol. "How to exercise a diabetes specialist should consult a specialist. Before cardiopulmonary exercise and exercise ability and exercise risk assessment should be carried out before starting the exercise. Patients with complications should follow the doctor's advice on lifestyle intervention." Guo Lixin said that for most diabetics, exercise is conducive to improving the body's ability to fight disease and helping to control blood sugar better. But in the serious stage of complications, sports should not be carried out, such as acute stage of retinal hemorrhage, retinal detachment, frequent hypoglycemia, severe fluctuation of blood sugar, severe diabetic foot infection, severe cardiopulmonary disease, renal insufficiency, and acute cerebrovascular disease. Guo Lixin reminded to prevent exercise-related hypoglycemia during and after exercise, especially the delayed hypoglycemia after exercise. Exercise should be mainly aerobic exercise, combined with resistance exercise (increasing muscle volume and muscle strength) and balance training according to the situation. According to the situation, choose the exercise you can adhere to, step by step, persevere, and pay attention to avoid sports injury. Family is the core unit to prevent and manage diabetes. Chinese incidence rate of diabetes has been increasing continuously as China's population aging and city development. 129 million Chinese have diabetes. Although diabetes management still faces many challenges, from the perspective of clinicians, Ji Linong, director of Department of Endocrinology, Peking University People's Hospital, said that diabetes is a preventable, controllable and controllable disease, and the family is the core unit to prevent and manage diabetes. Ji Linong believes that effective prevention of diabetes and good management must implement the "three level prevention" policy. Primary prevention refers to carrying out health education among the general population, increasing the awareness and participation of the crowd in prevention and treatment of diabetes, and improving the overall awareness of diabetes prevention and control among the community population. The two level of prevention is to screen out diabetes patients in high-risk groups, timely conduct health intervention, and standardize management so as to control their condition. The three level prevention is to control type II diabetes comprehensively, prevent disability or premature death caused by complications, improve the quality of life and prolong life. Ji Linong said endocrinologist should strengthen the popular science popularization of diabetes so that more people can raise their awareness of diabetes. For patients to give the right diabetes education, improve the comprehensive management of diabetes, so that patients with diabetes or no complications. In addition, we should respond to the strategy of chronic disease prevention and control at the grass-roots level, strengthen the training at the grass-roots level, and enhance the diabetes diagnosis and treatment ability of doctors at the grass-roots level, including community doctors and family doctors, so that people can get professional chronic disease management at their doorstep. Patients' demand for family care knowledge of diabetes is increasing. "Family plays an important role in the daily care of diabetics," said Zhao Fang, director of the nursing department of China-Japan Friendship Hospital. "In the family, we require the patient to keep a good health record, guide the family to play the role of supervision and support, help the patient build confidence and resist bad emotions, and the ultimate goal is to follow the doctor's advice, improve medication compliance, and avoid or delay the occurrence and development of complications." Zhao Fang has always recommended that patients use blood glucose monitoring diary at home. It can not only record blood glucose changes, but also provide doctors with invisible problems and misunderstandings in home self-management. "Diabetes needs lifelong management. Every diabetic patient may experience psychological resistance. In most cases, doctors can only rely on vague descriptions of their patients at home, such as fluctuations in blood sugar, dietary changes and resistance to drugs. If a detailed diary is kept, even a bad medicine may affect the doctor's tune. The decision-making of the whole treatment plan. " With the increase in the number of diabetic patients, the demand for family nursing knowledge is increasing. In recent years, the number of diabetes education outpatient clinics in many hospitals has increased. "Insulin needles can not be reused", "these parts can not be injected again" and other patients are easy to neglect. They are often exposed to the clinic. Subcutaneous adipose hyperplasia is thickened "rubber like" after subcutaneous injection of insulin in diabetic patients after long-term injection of insulin. Pathological changes. Injection of insulin at the site of adipose hyperplasia may lead to decreased or unstable insulin absorption and increase blood glucose fluctuation, which will lead to an increase in insulin injection dose. 90% of the patients believe that they have taken part in the rotation of the injection site, but in fact they only rotate in the same place, and there will also be subcutaneous fat hyperplasia. In addition, the repeated use of needles is also ten in patients with diabetes. According to statistics, if the needle is reused once, the subcutaneous fat hyperplasia rate will increase by 20%, and if it is reused six times, it will increase by 70% - 75%. If only one needle is used for a tube of medicine, it means that the subcutaneous fat hyperplasia rate is 100%. Clinically, Zhao Fang once met a patient who had injected insulin for more than 9 years but never checked the injection site by herself. "Some subcutaneous fat hyperplasia is not easy to be found by naked eye observation or palpation. It can only be judged by ultrasound, while most patients only rely on feeling and memory. The family should remind patients to do ultrasound once a year. For patients who have found hyperplasia, they should increase the frequency of examination," Zhao Fang said. (outlook new era)
Edit：Yuanqi Tang Responsible editor：Xiao Yu
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